queries on breast feeding
- Thread starter sandhya
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Sandhya, when I had my baby my neurologist said that there is no problem in brest feeding. He said that the baby is exposed to the anti-epileptic drugs in utero (in the womb) through out the pregnancy, so the drugs are not new to them and their bodies have adjusted to the low doses they receive. Babies who are bottle fed, and therefore not receiving the amount of anticonvulsant medication they received in utero, may experience temporary withdrawal symptoms such as tremor and agitation.
Research indicates that babies do not suffer any harmful effects from traces of anticonvulsant medication found in breastmilk. The physiological and psychological benefits of breastfeeding, both to the mother and to the child, are significant and if a women wishes to breastfeed she should be encouraged to do so.Breastfeeding is strongly recommended to promote maternal-infant bonding and to reduce the risk of infectious and immune disorders later in life. The mother must be aware that the infant may not like the flavor imparted to milk at certain times after taking her AED, and she should be advised to consider timing feeding or pumping milk to optimize nursing.
The anti-epileptic drugs may be present in the maternal milk to varying extents. Highly protein-bound anti-epileptic drugs have low concentrations in breast milk, whereas anti-epileptic drugs that have no protein binding are present in high concentrations similar to that of present in the serum. As long as AEDs are not changed after delivery, this is simply continuation of the same AED exposed to while in utero.
Most AEDs low to moderate excretion into breast milk. Levetiracetam, however, can have higher excretion into breast milk. The benefits of breastfeeding likely outweigh the risk of most AED exposure in the neonate; however, some drugs with age-specific side effects may warrant consideration. For example, whether lamotrigine has the same high risk of rash with exposure from breast milk or whether valproate has the same increased risk of hepatotoxicity is unknown. Presumably, because the infant tolerated the drug in utero, the risk for these age-specific toxicities is likely to be low.
It is advisable that metabolism and clearance of AEDs will remain higher while you will be lactating. your levels may increase when u stop breastfeeding, requiring a dose adjustment.
Few things I want to suggest are:
• If you take your seizure medicine just once a day, try to take it at the beginning of the baby's longest sleep interval, usually right after the bedtime feeding.
• If you need to take your seizure medicine more than once a day, breast-feed the baby immediately before you take a dose. That's when the level is likely to be lowest.
Research indicates that babies do not suffer any harmful effects from traces of anticonvulsant medication found in breastmilk. The physiological and psychological benefits of breastfeeding, both to the mother and to the child, are significant and if a women wishes to breastfeed she should be encouraged to do so.Breastfeeding is strongly recommended to promote maternal-infant bonding and to reduce the risk of infectious and immune disorders later in life. The mother must be aware that the infant may not like the flavor imparted to milk at certain times after taking her AED, and she should be advised to consider timing feeding or pumping milk to optimize nursing.
The anti-epileptic drugs may be present in the maternal milk to varying extents. Highly protein-bound anti-epileptic drugs have low concentrations in breast milk, whereas anti-epileptic drugs that have no protein binding are present in high concentrations similar to that of present in the serum. As long as AEDs are not changed after delivery, this is simply continuation of the same AED exposed to while in utero.
Most AEDs low to moderate excretion into breast milk. Levetiracetam, however, can have higher excretion into breast milk. The benefits of breastfeeding likely outweigh the risk of most AED exposure in the neonate; however, some drugs with age-specific side effects may warrant consideration. For example, whether lamotrigine has the same high risk of rash with exposure from breast milk or whether valproate has the same increased risk of hepatotoxicity is unknown. Presumably, because the infant tolerated the drug in utero, the risk for these age-specific toxicities is likely to be low.
It is advisable that metabolism and clearance of AEDs will remain higher while you will be lactating. your levels may increase when u stop breastfeeding, requiring a dose adjustment.
Few things I want to suggest are:
• If you take your seizure medicine just once a day, try to take it at the beginning of the baby's longest sleep interval, usually right after the bedtime feeding.
• If you need to take your seizure medicine more than once a day, breast-feed the baby immediately before you take a dose. That's when the level is likely to be lowest.